Vagina                                                                        
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Vagina (SVAGR)


- For resection specimens with carcinoma, including squamous cell carcinoma, adenocarcinoma and variants, carcinosarcoma, neuroendocrine carcinoma, and mixed epithelial neuroendocrine tumors. Summary recommended but not required for biopsy specimens. Not used for lymphoma or sarcoma.

Specimen and Surgical Procedure

Specimen, procedure.....................................................................

Lymph nodes submitted and/or identified in the specimen.................. yes/no

Tumor

Tumor site................................................................................... upper third/middle third/lower third/not specified

Tumor size...................................................................................  ___ cm

Histologic type..............................................................................

Histologic grade...............well/moderately/poorly differentiated/undifferentiated

Other tissue/organ involvement.....................................................

Lymphovascular invasion................................................not identified/present

Final Margins

Peripheral margin

       Invasive carcinoma at margin…………………….uninvolved/involved (specify location(s):)

       Intraepithelial neoplasia at margin…………….uninvolved/involved by high-grade squamous intraepithelial lesion (VAIN 2-3)/involved by adenocarcinoma in situ

Deep margin

       Invasive carcinoma at margin…………………….uninvolved/involved (specify location(s):)

       Intraepithelial neoplasia at margin…………….uninvolved/involved by high-grade squamous intraepithelial lesion (VAIN 2-3)/involved by adenocarcinoma in situ

Lymph Nodes* (required only if lymph nodes are present in specimen)

Total number of nodes examined: _____

Specify site(s)#: ____________________________

# Note: Information should include location and laterality of lymph nodes examined.

Specify lymph node(s) with tumor#: ____________________________

# Note: Information should include location and laterality of lymph nodes with tumor.

Number of nodes with metastasis (excludes ITCs): _____

Number of nodes with isolated tumor cells (ITCs) (0.2 mm or less): _____


Pathologic stage (AJCC 8th ed.)...................................................pT__N__M__


Gynecologic


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